Strategy Submission

Purpose The purpose of this group activity is to build on previous learning related to evidence-based practice that occurred during the term. Learners function as members of an Evidence-based Practice Committee at Eagles Community Hospital (named for the University mascot) and engage in the evidence-based practice process. Overview This activity uses the Johns Hopkins Nursing Evidence-based Practice (JHNEB) Model and learners are required to use the book, The Johns Hopkins Nursing Evidence-based Practice: Model and Guidelines (3rd ed.) by Dang and Dearholt. Prior to participating in this group activity, learners engaged in the following individual activities: 1. Learners explored and defined a clinical problem, described significance to nursing, and developed a PICOT question. 2. Next, learners identified keywords and established a search strategy to explore the evidence related to their PICOT question. 3. Learners conducted a literature search related to their PICOT question and selected three (3) pieces of evidence to appraise using the JHNEB Appraisal Tool for Research (Appendix E) and JHNEB Appraisal Tool for Non-Research (Appendix F). Leaners were required to select at least one (1) evidence summary and one (1) piece of primary evidence. 4. Finally, leaners created a summary matrix of the above evidence appraisals using the JHNEB Evidence Summary Tool (Appendix G). Learners will function as an Evidence-based Practice Committee (EBP) for Eagles Community Hospital. Learners are divided into groups based on the condition/topic selected at the beginning of the semester. Committee members identify a clinical practice (nursing intervention) that is well-supported by evidence and related to the symptom selected by the team. Members will conduct the synthesis process to identify a recommendation to address a PICOT question. The EBP committee will develop a PowerPoint presentation to promote adoption of the clinical practice by nursing staff (classmates). This activity is divided into three (3) parts. Part 1: Learners form an EBP Committee of 3-4 members who are interested in the same clinical problem. 1. The committee members will select a Committee Facilitator who will be responsible for keeping the team on task, assigning deadlines for members to submit additional materials, facilitate discussions, and report committee activities in class using report sheet by uploading to team files in the learning management system (LMS) or Google Docs. 2. Members will share their Individual Evidence-based Summaries with each other and discuss the following related to each member’s Evidence-based Summaries (discussion can take place face-to-face or in an online forum): a. What symptoms were addressed? b. What nursing interventions were identified? c. Was there significant evidence? d. What were the levels of evidence identified using JHNEB Evidence Level and Quality Guide (Appendix D)? Were all levels of evidence identified? If not, what was missing? e. Were there Clinical Practice Guidelines (CPGs) related to the interventions identified? 3. Members identify the levels of evidence missing and conduct a review for each. Then each member will bring evidence (1 piece) from each missing level back to the committee for review. 4. The Committee will summarize work using the EBP Committee Report sheet and the facilitator will present to the class the following week. Part 2: 1. The EBP Committee will review all members’ Evidence-based Summaries and select one (1) symptom and one (1) nursing intervention to address that symptom. The nursing intervention MUST be an autonomous intervention nurses can perform without requiring collaboration with a primary care provider (MD, OD, ANP, PA). 2. The Committee will write a PICOT question using the symptom and nursing intervention selected. 3. Next, the Committee will review all members’ Evidence-based Summaries and choose evidence specifically related to the symptom and nursing intervention selected and summarize the evidence using the Evidence Summary Matrix (combine previous evidence). a. Evidence Summary Matrix MUST include: i. Eight (8) pieces of evidence ii. A minimum of one (1) piece of evidence for each level b. Learners may need to conduct searches for additional evidence. 4. The Committee will engage in the Synthesis Process using the JHNEB Synthesis Process and Recommendations Form for the eight (8) pieces of evidence. The members will refer to Appendix H in textbook for Key Points for this discussion. 5. Once completed, the Committee Facilitator will present to class. Part 3: The Committee will review Synthesis of Findings and: 1. Finalize recommendation for clinical practice change 2. Determine which Translation Pathway represents the overall strength of the evidence (the overall strength should qualify for the Strong Pathway or the Good Pathway). 3. Discuss the fit and feasibility of the clinical practice change. 4. Finally, the EBP Committee will outline the results of the EBP Process and their Action Plan for Success using the Action Plan Planning Tool (Appendix I) in a PowerPoint presentation and present it to the class.